#BeautySchool: Are Your Knees Making You Look Older?

Question: I'm a fit woman in my mid-30s, but lately, I've noticed sagging skin around my kneecaps. It wasn't there a couple of years ago, and it's making my legs look older than they really are. What non-invasive treatment options do I have?

Answer: Knee wrinkles might seem like a silly concern—we can almost picture the SNL skit advertising the magic product to fix them—but according to Dr. Aaron Rollins, who specializes in laser and liposuction at Elite Body Sculpture in NYC, "they're actually a common complaint, even among patients in their late 20s to early 30s. Most often, the sagging skin in that area is due to weight loss, but natural loss of elasticity and sun damage also play a role as you age." But it's important to note, says Rollins, that "everyone has excess skin above their knees or they wouldn't be able to bend them, and about 25% of the patients who come to me [with this concern] actually have normal knees. I see patients worried about this before bikini season in Beverly Hills more often than one could imagine."

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If the sagging is abnormal or really bothersome, the surgical fix should be a last resort, as it involves lifting the whole upper leg, not just the knee. Instead, Rollins recommends trying firming laser treatments like Thermage and Ulthera, or sessions with a dermal roller, a device that uses tiny needles to create a tightening effect. If the problem isn't sagging, but fat ("I check by asking the patient to straighten their leg and then I pinch the inside of their knee. That's where knee fat lives, not above it"), AirSculpt is a laser that targets that and can be done in 15 minutes while the patient is awake.

What won't work? Botox, "which helps smooth out wrinkles but doesn't lift sagging skin;" working out, "though building up your quads with leg extensions at the gym can help;" and firming creams—"I've never met a single patient who said one worked at all."

The best preventative measures are to avoid yo-yo dieting, since "gaining and losing weight loosens the skin in the same way that blowing up a balloon and letting the air out ruins it," and wearing sunscreen—but you already knew that.

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